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Basic Rx Prescription Information

If any of the information does not apply, do not fill out the corresponding fields of the form. Please contact us if you need help understanding or entering your prescription. Prescription eyewear guide.

Progressive / Bifocal Specific Prescription Information

Segment Height and Pupil Distance (PD) are required and must be measured specifically for the frame you are ordering if you desire perfect fit for your prescription eyewear. Contact us if you have not had these measurements taken.

AddSeg HtDist. PdNear Pd

Right Eye (OD)

Left Eye (OS)

Doctor's Information

Name

Phone Number

Additional Comments & Instructions

This product may be covered by your FSA/HSA plan. If you would like to use your FSA/HSA debit card to purchase an eligible product covered by your account's plan, please give us a call at 800-504-5897 and we will be glad to take your order over the phone. Unfortunately at this time OpticsPlanet is unable to accept FSA/HSA debit cards via our online checkout.

Versace VE4265 Progressive Prescription Sunglasses Product Info

Formulated to be an ideal looking pair of rx shades, the Versace VE4265 Progressive Prescription Sunglasses helps keep your eyesight secure while improving your eyesight. These Progressive Sunglasses from the eyewear experts at Versace, were created implementing incredibly strong and resilient frame materials that is sure to grant you numerous years of reliable use. The Versace VE4265 Progressive Prescription Sunglasses is made using unique lens technology that will keep your eyes free of fatigue and tension by hindering possibly damaging Ultra violet rays. For quite a while, Versace has been an important part of the rx eyewear business and the Versace VE4265 Progressive Prescription Sunglasses is evidence of their determination and investment to furnishing you with the very best sun shades for the value. Our goal here at OpticsPlanet is without question to ensure that our customers leave happy, and the Versace VE4265 Progressive Prescription Sunglasses is one that we are pleased to offer. For the ideal way to look amazing while maintaining your eyesight in one piece and safe, look at the Versace VE4265 Progressive Prescription Sunglasses.